High cholesterol

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The production is directly regulated by the present cholesterol levels, and a higher intake in food leads to a net decrease in endogenous production. The main regulatory mechanism is the sensing of intracellular cholesterol in the endoplasmic reticulum by the protein SREBP (Sterol Regulatory Element Binding Protein 1 and 2). In the presence of cholesterol, SREBP is bound to two other proteins: SCAP (SREBP-cleavage activating protein) and Insig-1. When cholesterol levels fall, Insig-1 dissociates from the SREBP-SCAP complex, allowing the complex to migrate to the Golgi apparatus, where SREBP is cleaved by S1P and S2P (site 1/2 protease), two enzymes that are activated by SCAP when cholesterol levels are low. The cleaved SREBP then migrates to the nucleus and acts as a transcription factor to bind to the "Sterol Regulatory Element" of a number of genes to stimulate their transcription. Amongst the genes transcribed are the LDL receptor and HMG-CoA reductase. The former scavenges circulating LDL from the bloodstream, while HMG-CoA reductase leads to an increase of endogenous production of cholesterol.

Cholesterol is excreted from the liver in bile; under certain circumstances it can crystallise in the gallbladder to become a major constituent of gallstones, although lecitin and bilirubin gallstones can also occur.

Some doctors, known as "the dissidents of the lipid hypothesis", claim that cholesterol itself is a healthy nutrient and that the whole lipid hypothesis, which says cholesterol is linked with heart disease and atherosclerosis, is incorrect. Some information can be found at the Weston A. Prince foundation.

The Healthy Refrigerator
Nutritional advice and information to reduce risk of heart problems or manage heart conditions. Recipes, foods suggestions, facts about heart disease.
InteliHealth: Cholesterol
Includes basic information, treatment options, and an ask-the-expert section. Reviewed by Harvard Medical School.
Ask The Dietitian
Question and answer format about cholesterol and saturated fat.
National Heart, Lung And Blood Institute
In-depth look at cholesterol and why it matters, heart disease, benefits from lowering, having it checked, diet, exercise, weight and many more topics are discussed.
Rose Medical Center - High Cholesterol
An article about cholesterol, discussing the interpretation of the numbers, good and bad cholesterol as well as how to fight it when it is high.

High cholesterol